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Rand Institute Report Found Better-Quality Health CareIn States That Medical Association Claims Are in Throes of Malpractice “Crisis”

WASHINGTON, D.C. – This week, the U.S. House of Representatives will cast the fifth congressional floor vote on medical malpractice legislation in 14 months. The vote comes only a week after a Rand Institute report found generally low-quality health care in the United States – care that is lower still in states with caps on lawsuit damages.

“The medical lobby has a lot of gall to be asking for favors from Congress,” said Public Citizen President Joan Claybrook. “It should look in the mirror and address the health care quality problems identified in the Rand report, rather than asking for handouts.”

The American Medical Association (AMA) claims that malpractice lawsuits are creating “crisis” conditions in 19 states. Yet the Rand Institute gave its highest rating for health care quality to Seattle, located in one of those “crisis” states. Overall, Rand found that the quality of health care was higher in cities in six AMA “crisis” states that Rand studied than in two of the states the AMA says are “doing OK” – California and Indiana. In fact, the Rand report singled out Orange County, Calif., and Indianapolis, Ind., as delivering the lowest-quality cardiac care.

The House approved a malpractice bill last year, while the U.S. Senate rejected three different versions of the measure this year. All the bills would have arbitrarily limited the damages available to those injured by malpractice, which would greatly harm those patients who have been most injured by malpractice.

The Rand report studied patients’ medical records in 12 metropolitan areas and compared their care to recognized standards and quality indicators. It found that overall, patients receive only about 55 percent of the care recommended for their conditions.

But there were local variations, and in most categories, the best care was delivered in cities where the AMA claims a malpractice “crisis” exists: Miami (diabetes, pulmonary), Seattle (preventive), Cleveland and Syracuse(cardiac). The Rand Institute report is available at http://www.rand.org/news/press.04/05.04.html.

Preventable medical errors kill up to 100,000 people in the United States each year and injure hundreds of thousands more. But research shows that most malpractice payments are made by just a small number of doctors. Public Citizen’s analysis of National Practitioner Data Bank data shows that just 5.4 percent of doctors, all of whom have made two or more malpractice payouts, have been responsible for 52.6 percent of all payouts since September 1990. Just 2 percent of doctors, all of whom have made three or more malpractice payments, have been responsible for 31.1 percent of all payouts since September 1990.

Damage caps would do nothing to lower insurance rates; even insurers have said they would not lower malpractice premiums if damages were capped. Insurers raise malpractice premiums when the economic cycle dips. A solution, then, is for state medical boards to be more diligent in disciplining doctors who commit malpractice.

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